Table 6.
The indications and complications of different surgical approaches to thalamic tumors
| Surgical approach | Indications | Complications |
|---|---|---|
| Anterior transcallosal approach | ① The epicenter was located in the anterior thalamus with/without anterior extension to the fontal horn of the lateral ventricle or callosum; | The approach is limited laterally by stretching of the pericallosal artery; some cases suffered from transient mental disorders or memory deficits |
| ② The epicenter was located in the medial thalamic region with/without extension into the third ventricle | ||
| Transfrontal approach | The epicenter was located in the anterior thalamus and extended too much laterally (over 2 centimeters from the lateral broader to the middle line) | High risk of postoperative seizures |
| Transtemporal approach | ① The epicenter of the tumor was located in the lateral thalamic region with/without lateral extension to the basal ganglia, adjacent lobes, or the gyrus, or extending beneath the temporal cortex; | Visual field defects due to injury to the optic radiation and language disturbances on the dominant side |
| ② Tumors arising from the junction of the thalamus and the cerebral peduncle and extended to the thalamic and peduncle to a similar extent | ||
| Transinsular approach | The epicenter of the tumor was located in the lateral thalamic region with lateral extension to the basal ganglia | High risk in internal capsule injuries |
| Subtemporal approach | ① Tumors located in the pulvinar with posterior extension toward adjacent structures; | High risk in cortical draining veins and temporal lobe injuries when elevating the temporal lobe |
| ② Tumors arising from the junction of the thalamus and the cerebral peduncle with most of their mass located in the thalamic region | ||
| Transpariento-occipital approach | Tumors arising from the junction of the thalamus and the cerebral peduncle occupied the cisterna ambiens and extended inferiorly to the infratentorial area | Visual field and memory deficits, due to injury to adjacent optic radiation of the crus fornicis covering the thalamus |
| Posterior transcallosal approach | Pulvinar tumors that are primarily located medially (within 1 centimeter from the lateral broader to the middle line) | High risk in optic radiation injuries |